Individual
BRIAN COLLETTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
356 OAKLAND AVE, ROCK HILL, SC 29730-4064
(803) 980-3937
(803) 980-5353
Mailing address
356 OAKLAND AVE, ROCK HILL, SC 29730-4064
(803) 980-3937
(803) 980-5353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1202
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D12029
—
SC
Enumeration date
08/22/2006
Last updated
03/07/2008
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